Department of Pathology, University of Virginia, Charlottesville, Virginia, USA.
Departments of Laboratory Medicine and Pediatrics, Yale University, New Haven, Connecticut, USA.
Transfusion. 2021 Jul;61(7):2169-2178. doi: 10.1111/trf.16554. Epub 2021 Jun 28.
Despite the significant adverse clinical consequences of RBC alloimmunization, our understanding of the signals that induce immune responses to transfused RBCs remains incomplete. Though RBC storage has been shown to enhance alloimmunization in the hen egg lysozyme, ovalbumin, and human Duffy (HOD) RBC alloantigen mouse model, the molecular signals leading to immune activation in this system remain unclear. Given that the nonclassical major histocompatibility complex (MHC) Class I molecule CD1D can bind to multiple different lysophospholipids and direct immune activation, we hypothesized that storage of RBCs increases lysophospholipids known to bind CD1D, and further that recipient CD1D recognition of these altered lipids mediates storage-induced alloimmunization responses.
We used a mass spectrometry-based approach to analyze the changes in lysophospholipids that are induced during storage of mouse RBCs. CD1D knockout (CD1D-KO) and wild-type (WT) control mice were transfused with stored HOD RBCs to measure the impact of CD1D deficiency on RBC alloimmunization.
RBC storage results in alterations in multiple lysophospholipid species known to bind to CD1D and activate the immune system. Prior to transfusion, CD1D-deficient mice had lower baseline levels of polyclonal immunoglobulin (IgG) relative to WT mice. In response to stored RBC transfusion, CD1D-deficient mice generated similar levels of anti-HOD IgM and anti-HOD IgG.
Although storage of RBCs leads to alteration of several lysophospholipids known to be capable of binding CD1D, storage-induced RBC alloimmunization responses are not impacted by recipient CD1D deficiency.
尽管 RBC 同种免疫反应会带来严重的临床后果,但我们对于引发对输注 RBC 免疫反应的信号的理解仍不完整。尽管 RBC 储存已被证明会增强鸡卵溶菌酶、卵清蛋白和人类 Duffy(HOD)RBC 同种抗原小鼠模型中的同种免疫反应,但导致该系统中免疫激活的分子信号仍不清楚。鉴于非经典主要组织相容性复合体(MHC)I 类分子 CD1D 可结合多种不同的溶血磷脂,并直接引发免疫激活,我们假设 RBC 储存会增加已知与 CD1D 结合的溶血磷脂,并且接受者 CD1D 对这些改变的脂质的识别介导储存诱导的同种免疫反应。
我们使用基于质谱的方法来分析在储存小鼠 RBC 期间诱导的溶血磷脂的变化。用储存的 HOD RBC 转输给 CD1D 敲除(CD1D-KO)和野生型(WT)对照小鼠,以测量 CD1D 缺陷对 RBC 同种免疫的影响。
RBC 储存导致已知与 CD1D 结合并激活免疫系统的多种溶血磷脂发生改变。在输血前,CD1D 缺陷型小鼠的多克隆免疫球蛋白(IgG)基线水平低于 WT 小鼠。在接受储存的 RBC 输血后,CD1D 缺陷型小鼠产生了类似水平的抗-HOD IgM 和抗-HOD IgG。
尽管 RBC 储存会导致几种已知能够与 CD1D 结合的溶血磷脂发生改变,但储存诱导的 RBC 同种免疫反应不受受者 CD1D 缺陷的影响。